Providers seeing a 2 percent payment decrease on their Remittance Advice (RA) is due to a mandatory sequestration payment reduction. Claim adjustment reason code (CARC) 253 is used to report the sequestration reduction. The code will appear as a CO 253 on the RA ‘Sequestration-reduction in federal payment’ as the reason. For the Medicare Fee-for-Service […]
Insurance will deny the claim with denial code CO 29 – the time limit for filing has expired, whenever the claims submitted after the time frame. The time limit is calculated from the date service provided. Each insurance carrier has its own guidelines for filing claims in a timely fashion. Some are as short as […]
You might have received a denial with claim adjustment reason code (CARC) CO B9. Possible reasons for this denial message could be: The patient is enrolled in Hospice on the date of service Medicare Part B only pays for physician services not related to Hospice condition and not paid under arrangement with Hospice entity Patient’s […]
Medical nutrition therapy (MNT) is a key component of diabetes education and management. MNT is defined as a ‘nutrition-based treatment provided by a registered dietitian nutritionist.’ It includes ‘a nutrition diagnosis as well as therapeutic and counseling services to help manage diabetes. Studies have documented an association between MNT delivered by a registered dietitian and […]
CMS recently announced that it will provide parity in payment for telephone/audio-only services. Specifically, Medicare payment for the telephone evaluation and management visits would be equivalent to Medicare payment for office/outpatient visits with established patients’ effective March 1, 2020. This means that payment for CPT codes 99441-99443 would increase from a range of about $14-$41 […]
The Centers for Medicare & Medicaid Services on 14th Oct 2020, announced that it has expanded the list of telehealth services that Medicare will pay for during the COVID-19 public health emergency. Medicare will begin paying eligible practitioners for these 11 newly approved telehealth services delivered via telehealth, including certain cardiac rehabilitation and monitoring services. […]
Telemedicine was originally envisioned for its use in rural areas. Before the COVID-19 pandemic, telemedicine was started gaining traction in hospitals, large group practices, and online telemedicine services. Now after the COVID-19 pandemic, almost every medical specialty is finding a way to adopt telemedicine. There are some specialties where telemedicine adoption is comparatively high like […]
The Centers for Medicare & Medicaid Services (CMS) made many changes to adapt patient care amid the COVID-19 pandemic. Expanding Medicare coverage to include a range of services through audio-only telehealth visits is one of them. Let’s understand some of the basic coding guidelines for audio-only telephone visits: CPT Code 99441-99443 -audio-only telehealth Code Description […]
Every healthcare provider has to apply for initial medical credentialing and must get re-credentialed after every 2-3 years. It’s a tedious and time-consuming task, but a necessary one, as it’s required before a healthcare organization or practice can bill on your behalf. The complete medical credentialing process can take up to 3-4 months to complete […]
On 10th Nov 2020, the American Medical Association (AMA) published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations for the novel coronavirus (SARS-CoV-2). The CPT editorial panel has approved a unique CPT code for each of two coronavirus vaccines as well as administration codes unique […]
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